Three medical professionals walked into the examination room where I was waiting for them late last year – my oncologist and a registered nurse, both of whom I knew, and a social worker.

The four of us sat close together as the oncologist told me my cancer, after a period of remission, had reappeared in a lung and in my peritoneum, and that it could not be cured.

Particularly after a period of several months when no cancer had been detected, the news was, if not entirely unexpected, a stunner. I was shaken and I cannot imagine getting through the ensuing conversation about treatment possibilities without the doctor holding my hand.

That simple human gesture, the warmth and reassurance of another person's touch, is what anyone needs when being confronted with terrible news.

Nevertheless, last week, a dying man and the granddaughter who was with him in a California hospital room was informed he had only a few days to live by a robot doctor. Take a look at the phone video recorded by the granddaughter:

Seventy-eight-year-old Ernest Quintana died two days later. As CBSnews.com reported:

”Granddaughter Annalisia Wilharm, 33, was alone with Quintana when a nurse popped in to say a doctor would be making his rounds. A robot rolled in and a doctor appeared on the video screen. Wilharm figured the visit was routine. She was astonished by what the doctor started saying.

"'This guy cannot breathe, and he's got this robot trying to talk to him,' she said. 'Meanwhile, this guy is telling him, “So we've got your results back, and there's no lung left. There's no lung to work with.”

“Wilharm said she had to repeat what the doctor said to her grandfather, because he was hard of hearing in his right ear and the machine couldn't get to the other side of the bed.”

A hospital spokesperson later apologized to the family for the insensitivity but went on to say that the characterization of the live video physician as a robot was inaccurate. According to CNN,

”Gaskill-Hames, the hospital spokeswoman, said the health care provider is 'continuously learning how best to integrate technology into patient interactions.'

"'In every aspect of our care, and especially when communicating difficult information, we do so with compassion in a personal manner,' she said, adding that the term 'robot' is 'inaccurate and inappropriate.'"

In what world, I wonder, is it good and right and compassionate to hear you'll be dead in a few days from a screen? I can't be sure but none of the reports I read of this incident made mention that the “robot” checked to see that the patient was not alone when this news was delivered.

Having my hand held by the doctor while she told me about the change in my condition made all the difference to me. I'm not sure I could even have parsed the new diagnosis if I had been alone with a robot when the words were said. And how would I have asked questions?

For the record, I'm not against telemedicine in general; I think there should be more of it.

Often enough when I see one of my physicians, it's not for an exam or painful-to-hear information; it's a discussion of how I'm doing, how my body is tolerating chemotherapy, what concerns me that day.

We could as easily have that conversation via video and make an in-person appointment if that became necessary.

But to repeat myself: In what world is it good and right and compassionate to hear you'll be dead in a few days from a screen? And why wouldn't hospital personnel, who work every day with ailing, vulnerable people, already know the answer to that?

Comments

While I am super happy that you have a physician who holds your hand while giving you bad news, I would not want to be treated in that manner. Of course, I'm saying that without ever having had to receive news remotely comparable to yours, Ronni. It is just that each of us is different.

Within the past 15 years, since retiring, I have learned to accept and to give physical hugs (thanks to being a volunteer in disaster relief operations); but, I am still not comfortable having non-relatives touch me. I have never had a manicure, pedicure, or massage. The thought of the touching sends chills down my spine. So, if I could interact with a screen for all of my medical care, I would probably be just as happy.

That said, I will always send you e-hugs. I value your friendship, your work, your intelligence, and your compassion. May your medical team continue to treat you well (by your definition!)

P.S. I agree that telemedicine is not robotic medicine; although, many surgeries are now performed by human-controlled robotic equipment - surgeries that would be nearly impossible, by human hand. That's a whole different thing from delivering bad news, though.

I've always thought we give ourselves more credit for humanity than we deserve, especially in business - and health care these days is very much an investor-owned business. I know of no one who would wish such an experience for their loved one but very few who would think twice about it for another's loved ones. A report will be made and cost-effective cosmetic changes will be made but business is business. Humanity's best days are behind us.

This should be an editorial in every newspaper. If there is anyone who could put this practice in its proper context, it’s you, Ronni. Thank you for sharing what it feels like to get this kind of news, and how a HUMAN might need to intereact with another at a time like this. We need you to keep speaking for us all (or at least, most of us).

Another shocking story of how our health care system has become dehumanized.

I saw on Lester Holt's national nightly news a few days ago about a man who has Stage 4 Pancreatic Cancer (sound familiar?) and is in Hospice care in a hospital I believe in the mid-west.

"Someone" called 911 and said somebody was using marijuana in the room and the local police showed up. They searched his bags looking for the "drugs" and found nothing but CBD capsules that this poor guy was taking to ease his discomfort. His granddaughter videotaped the encounter and it was a disgrace.

The hospital eventually apologized after the national exposure and promised to "do better" in protecting their patients. Damage done.

This story appalled me. Is this hospital crazy? I must echo what others have said, in triplicate.

There is a defense mechanism called reaction formation, in which you avow a feeling opposite to what you are really feeling, because acknowledging the real feeling would cause you to be flooded with all kinds of anxiety, guilt, rage, and so on. So I always wonder when I see local health care systems named "Dignity" or "Mercy". I sort of hate being such a cynical old bitch, but I am!

I am outraged by this!! What a horrible thing to do to a fellow human being. Whether or not you might need a hug, you certainly deserve the compassion and humanity of a personal visit to deliver this kind of devastating news. No wonder he died 2 days later. He might have had a heart attack on the spot. And his granddaughter was totally unprepared to deal with the situation. She thought this was a routine "visit". I could scream!

I know I'm an oddball, but I'd much prefer interacting with a tele doctor in this instance than somebody holding my hand. I would hate that. I don't like being touched even by people I love and certainly would not want my PA doing it while giving me terrible news. And I certainly would not want several people there. I much prefer to be able to process this kind of thing alone. Of course, later I'm sure I've have questions, but in the moment I'm pretty sure I'd be too numb to formulate them and would appreciate being alone to process this kind of devastating news. It seems to be the "best practice" would be having the doctor/hospital find out beforehand patient preferences.

Glad your being offline was just tech related though I'm sorry you had the hassle of dealing with computer issues.

Whoever made the decision to deliver this terminal message in such a manner to this patient demonstrated the height of poor judgement to put it mildly. I would like to think caring nurses as I have known, would have attempted to dissuade this physician from delivering his message on a robot's computer screen. That's pretty "cold! Also, it's totally insensitive to the patient's special needs with hearing loss to say the least. I wonder if they even bothered to establish if anyone and who it was might be in the room with him.

As for the touching, I found in my professional health care work, discerning whether or not an individual welcomed this kind of physical contact was very important. Assuming everyone would respond to even a hand on the shoulder, or a hand-over-hand touch, pat on the arm, would be a mistake. There can be a number of reasons, including a neurological sensitivity for some, that makes touch from others repellent. For those who derive comfort from touch, which can be considered an intimate act from doctor, nurse, or even a family member or friend, if there was ever a time they would welcome it, as you describe, a terminal message would be that time.

Sensitivity to others is a key function in the delivery of health care in my personal and professional opinion. I would hope there will always be individuals in the health care professions who will champion, insist, the caring aspect in delivery prevails as an essential component of medical services. We should continue to make clear our expectation for such care and let our reactions be known when service falls short as in this story you cite.

So glad that you are back! Gotta love these computers, except when they go wrong.

As for the doctor delivering news via a robot computer, if it were my family, I would dispute the charge for that doctor visit. Cause you KNOW they're gonna charge for it. And I echo those who pointed out that they didn't even take the patient's hearing loss into consideration...what a sorry story.

In my experience, advocating for patients, Kaiser will do anything and everything to cut costs. I wouldn't be surprised to see them send form letters to dying patients saying; "You'll be dead soon. Make it quick, we need your bed for someone who is going to keep paying premiums."

Telemedicine has its place, telling someone they are standing on the threshold of death isn't one of them. It doesn't have to include touching, but news like that should at least be delivered with compassion.